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Medicare Claims

ProvidersSubmit a ClaimMedicare Claims

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Submitting Medicare claims

We have a contractual arrangement with the Centers for Medicare & Medicaid Services (CMS) to provide SeniorCare (Cost), SeniorCare Advantage HMO, SeniorCare Advantage PPO and Vital Traditions (HMO) Medicare Plans. The following applies to our SeniorCare (Cost) plans only.

Part A Services

All claims billed on UB-04 for Part A services should be filed with Medicare Part A. We do accept crossover claims from Medicare. If you bill secondary claims to us for Medicare primary claims, we are now receiving daily electronic files from Medicare, and will be processing provider payments from these electronic Medicare submissions.

    Part B Services

    We act as the Medicare intermediary for some Part B services for SeniorCare members only. Please refer to your contract for further details.

    Exceptions

    CPT codes 90801–90899 for psychiatric services and 90918–90999 for dialysis should be filed directly with CMS.